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States Are Using Medicaid to Target Social Needs — Should Your State Do the Same?

by Axios | 10.30.18

States are increasingly using their Medicaid programs to focus on addressing social determinants of health, like access to housing and food, as a way to make health care more comprehensive and cost-effective.

The big picture: These state Medicaid efforts are part of a growing recognition that improving overall population health — and health equity — will have to include interventions beyond the traditional health care system.

Growing awareness of the connection between social factors and health has coincided with the Affordable Care Act's Medicaid expansion, and an increased focus on making sure health insurance is effective.

  • For example, people's nutrition suffers when they don't have transportation to a grocery store or access to healthy food options — and that leads to adverse health consequences.

States are taking different approaches to addressing these factors, and are doing so through waivers, optional Medicaid authorities and their contracts with managed care organizations.

  • "I wouldn’t call it a 'blue state' trend, since there are lots of states looking at this, even red ones," said Matt Salo, executive director of the National Association of Medicaid Directors. "I would call this a focus on the social determinants of health and how Medicaid can provide and/or pay for non-traditionally medical services like housing, food, and efforts to address social isolation."

How it works, per a Kaiser Family Foundation brief:

  • Oregon and Colorado have both established regional organizations that focus on integrating social, behavioral and physical elements of health. One Colorado organization uses Meals on Wheels to help Medicaid enrollees discharged from the hospital get food.
  • Texas has installed refrigerators in some homeless shelters so people can refrigerate their insulin.
  • A California waiver increases hospital coordination with social services and welfare offices.
  • The Louisiana Department of Health is working with the state housing authority to reduce homelessness and institutionalization of people with disabilities.

Where it stands: While the Obama administration was very supportive of these efforts, the Trump administration is devoting more attention to other parts of its agenda, like Medicaid work requirements. But states are still active, and the Trump administration is approving state proposals along these lines.

Caitlin Owens

Illustration: Sarah Grillo/Axios

Axios

Written by Axios

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(20)
  • Bradford
    10/30/2018
    ···

    Absolutely not. Food and housing are already subsidized by other federal programs. If a state wishes to add other subsidies, they should pay for it themselves. If we don’t stop frivolous spending we will bankrupt future generations.

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  • John
    Voted Support
    10/30/2018
    ···

    There should be basic living standards provided to people in this country. These should include : universal single payer healthcare, cradle to grave; guaranteed minimum living wage; affordable/free public transport; access to fresh, healthy food; community support and wellness visits; and clean water and clean air.

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  • Leon
    Voted Oppose
    10/30/2018
    ···

    Then what is SNAP for?

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  • awesomepaulsome
    Voted Support
    10/30/2018
    ···

    It sounds good to me, though to fully support it or not, I would personally need to do a more through investigation of the issues related.

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  • Hal
    Voted Oppose
    10/31/2018
    ···

    I oppose this because Medicaid was not intended for illegals (or the cost of their children). Instead why don’t we allocate the Medicaid budget back to states as block grants.

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  • Miles
    Voted Support
    10/30/2018
    ···

    I think it’s a great idea, only if they have a surplus to spend. Directing all of the money into social needs is not a great move, as that isn’t what the funds are for.

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  • Catherine
    Voted Support
    10/30/2018
    ···

    We need to be helping the poor and disenfranchised especially the elderly and the handicapped in any way that we can

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  • Bryan
    Voted Support
    10/30/2018
    ···

    I think States should have a choice on this issue, but Medicaid funds are limited and if this choice leaves none for the intended purpose, then that is the consequence of any allowed but unintended usage.

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  • Nancy
    Voted Support
    10/31/2018
    ···

    ECONOMIC FACTORS PLAY A LARGE FACTOR IN MOST PEOPLES LIVES----YOU DON'T HAVE A DECENT PAYING JOB YOU CAN NOT AFFORD TO GO TO WORK--GET GROCERIES---SEE THE DOCTOR ETC. SYSTEM NEEDS TO BE CHANGED--TAX SCAM REPEALED--HIGHER WAGES ----GREEDY PEOPLE GETTING LESS!!!!

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  • D.
    Voted Support
    10/30/2018
    ···

    I do support this... BUT, it should be used as a guideline. There many that don’t collect Medicaid but need a great deal of help. This includes the homeless, disabled and mentally ill. No one should be left out but this way does leave out many.

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  • Robert
    Voted Support
    10/30/2018
    ···

    Ok by me😁

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  • Caren
    Voted Oppose
    10/31/2018
    ···

    NO! Our government is trillions of dollars in debt. Our president is working and trying hard to get our country back in good financial shape. To cover the expenses and healthcare of immigrants is to take it away from native born citizens.

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  • Linda
    Voted Support
    10/31/2018
    ···

    Using medicaid to help social needs might be a good idea. But only if the GOV. is going tp provide the funding. Trump & the GOP congress are trying to cut social security, medicare, medicaid, snap, school funding, etc. There must be NO work requirement for any of this. Help the people who need help. They can get the funding by over turning the tax scam that only helps the wealthy & corporations.

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  • Cindy
    Voted Support
    10/30/2018
    ···

    Of course. Social economic factors influence health outcomes.

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  • Tim
    Voted Support
    10/30/2018
    ···

    I’d support government assistance with those areas, but for organizational and funding reasons, it shouldn’t part of what is properly a medical assistance program.

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  • Katharine
    Voted Support
    10/30/2018
    ···

    I’m all for the COMMON GOOD PERSPECTIVE when it comes to public education, HEALTHCARE, housing, and public safety... these are hallmarks in healthy, vibrant communities. As Americans, we are responsible for honoring those values of life most of us hold in common.. Life, Liberty, and the pursuit of Happiness. We will reap great benefits when we are able to sacrifice for the common good.

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  • David
    Voted Support
    10/30/2018
    ···

    Looks like a idea

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  • Rebeca
    Voted Support
    11/02/2018
    ···

    Yes because there are some people that can be benefit from this and it would be a great help for those that need more this program or project

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  • Joanna
    Voted Support
    10/30/2018
    ···

    If we were really a Christian nation, we would be doing everything to insure that everyone has free access to healthcare and education, as well as a job paying a livable wage, access to affordable housing, and a healthy diet, not just junk food.

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  • Doug
    Voted Oppose
    10/31/2018
    ···

    WHILE THE ISSUES DISCUSSED ARE ALL VALID, THERE IS A DESPERATE NEED TO WITHDRAW FROM ALL PROGRAMS THAT TEND TO INCREASE SOCIALISM AND DILUTE, OR INTERFERE WITH APPLICATION OF THE CONSTITUTION.

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